Complications and failures of open and arthroscopic acromioplasties

Controversy exists over the optimal method of surgical treatment for chronic impingement refractory to conservative treatment. Success comparable with the "gold standard" open anterior acromioplasty has been reported using arthroscopic techniques, but failures and complications have been reported with both modes of operative intervention. Overall, the percentage of satisfactory results differs only slightly by approach, and the causes of failure can be divided into three categories: (1) diagnostic failures, (2) treatment failures, and (3) complications. The keys to obtaining a successful result are making the correct diagnosis and performing a technically sound procedure while avoiding complications. This issue is of importance, because operative treatment of patients with failed acromioplasties offers inferior results to primary acromioplasty.